Can CBD Help With Social Anxiety?
March 30, 2019
I noticed an interesting effect personally from CBD.
When I would take it before basketball, I shot much better.
I had less doubt about my shot and less insecurity about how I would be viewed by the other players.
Noticeably different.
After all, most of basketball is a mental game and "confidence" figures into that effect.
Pro basketball player's shooting percentages drop approximately 10% during a game versus practice.
They're pros who have probably shot 10,000+ times in their life!
It's like suddenly missing your mouth with the fork one out of ten times.
This is a perfect segue into social anxiety disorder which revolves around a fear of judgment or being negatively evaluated in social situations.
For some people, these situations cause nervousness but for others, they're downright anxiety-ridden.
Social anxiety disorder or SAD.
Not to be confused with Seasonal Affective Disorder (basically depressed in the wintertime).
Social anxiety is also different from general anxiety as it's specific to certain (social) situations.
This puts it more in the "phobia" camp.
Social anxiety is currently listed in the top 3-4 mental health issues worldwide so it's very prevalent.
Estimates put it at 7% of the population which translates into millions of people.
We're going to go deeper than most sites on social anxiety disorder.
Before we even jump into how CBD might work with social anxiety, we want to understand what's happening in the brain.
Otherwise, you can find generic info on 100's of other sites.
Let's get started.
We'll cover these topics:
- What is happening in the brain with social anxiety
- Where is the seat of insecurity or shame in the brain for social anxiety
- Where do negative thoughts come from in the brain with social anxiety
- The endocannabinoid system and social anxiety
- Can CBD help with social anxiety
- How much CBD to take for social anxiety
- The best CBD for social anxiety
Lots to cover.
What is happening in the brain with social anxiety
This is going to get really interesting.
We're going to talk about two distinct brain areas tied directly to social anxiety disorder.
- Amygdala - Prefrontal Cortex circuit
- Pregenual Anterior Cortex
Before your eyes glaze over, trust us...we're going to keep it real simple.
You can always research further from here but let's get a lay of the land before we look at CBD and the endocannabinoid system that it works in.
We'll start with our reptilian brain!
The Amygdala - Prefrontal cortex circuit and social anxiety
First, you have the amygdala, an almond-shaped part of the brain that is thought of as our emotional center of the brain.
It colors our perception of things like fear and pleasure.
It's also the first relay (after the thalamus) for fight or flight responses.
You know...that initial startle reaction when a car almost hits you.
Heart rate jumps. Focus intensifies. Everything tightens up .
Sound familiar?
Yes, the amygdala is directly implicated in both general anxiety and social anxiety.
It's incredibly fast in response and basically on the lookout for threats.
These days, it's less concerned with tigers jumping out of a bush than with that snarky glance a woman just gave you at the party.
It's a one-trick pony though and it only knows one way to respond either way.
Fear. Threat. Panic!
So what keeps the Amygdala in check?
The prefrontal cortex.
It's a much newer part of the brain in terms of evolution (just millions of years).
It contains "spindle cells" which are only found in humans, primates, cetaceans (dolphins), and elephants!
It's the rational seat of our brain involved with complicated planning and calculations.
It's the opposing force to our Amygdala.
The Amygdala reacts almost instantly to any threat.
It has to!
If ancestors had a slow-poke Amygdala, they probably didn't survive.
Usually, a threat comes into the Amygdala to assess how to instantly respond.
The signal then goes to the prefrontal cortex for further analysis.
In a normal response, the prefrontal cortex sends a signal to relax (downregulate) back to the Amygdala if it sees that the threat is no big deal.
With people that have social anxiety disorder (or anxiety in general), there are two potential issues here:
- A hyperactive Amygdala that responds too strongly
- A prefrontal cortex that actually tells the Amygdala to react more strongly in social situations
We'll get into it further but that loop explains anxiety in general.
Social anxiety adds another wrinkle.
The fear of judgment or embarrassment recruits another circuit in the brain.
Hello, pregenual anterior cingulate cortex!
Say that 5 times fast.
Pregenual anterior cingulate cortex and social anxiety
This is where social anxiety gets its peculiarities.
It's also where this gets very interesting.
First, think of the cingulate cortex as a relay or connector between the Amygdala (emotional brain) and prefrontal cortex (rational brain).
Hmmm...that might be of interest in the whole social anxiety circuit we discussed above.
Now the pregenual part of this relay gets even more interesting.
Shame, embarrassment, self-doubt mainly originate from this specific area!
right pregenual anterior cingulate cortex (pACC) gray matter volume was the only brain region that was a significant predictor of self-conscious emotion.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3624960/
Maybe more importantly….
Smaller pACC volume was associated with attenuated physiological and behavioral self-conscious emotional reactivity, and this relationship was not specific to diagnosis.
This means that smaller versions of this area were tied to less self-conscious behavior.
Now don't fret...we'll get into how the brain is a dynamic system which can and does change.
But it's interesting to find the seat of doubt, shame, and embarrassment at the junction of our emotional and rational brains!
It's not just some vague, nebulous fear we can't pin to anything.
There's a root and where there's a root, there can be understanding and action!
Interestingly, there are other parts of the cingulate cortex tied to very human attributes such as morality, cost-benefit analysis, and even " performance monitoring and error detection"
https://en.wikipedia.org/wiki/Anterior_cingulate_cortex
You know...things that make us distinctly human!
We geek out a bit..sorry.
A few more aspects to consider with social anxiety.
There can be other contributing factors:
- Hereditary probability with family members that have social anxiety
- Negative experiences earlier in life
- Potential genetic role for serotonin transporter gene SLC6A4
- Negative or overreacting parenting styles
More info here:
https://www.mayoclinic.org/diseases-conditions/social-anxiety-disorder/symptoms-causes/syc-20353561
A few notes on these potential influences.
Hereditary contributions can either be a function of genetics or fear response modeling.
We'll talk about serotonin signaling later with CBD and as for response modeling, we'll get into neurogenesis and CBD's interaction with "forgetting" bad memories.
It's one of our favorite attributes of CBD.
This gets to the heart of the brain's ability to change after negative experiences, bad parenting styles, and more.
That leaves serotonin and brain area signaling.
As for the gene implication, CRSPR is coming sooner than you think .
We'll see what can be done downstream from the gene itself.
Finally...the opioid system.
Yes, we have an opioid system in the brain which primarily handles pain but also has an interesting intersection with social reward!
This system has been tied directly to our interpretation of social acceptance and rejection:
In addition, MOR activation in the pregenual ACC was correlated with reduced negative affect during rejection.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3814222/
MOR is part of your opioid system in the brain but did you notice the other system...pregenual anterior cingulate cortex??
That's the seat of embarrassment, shame, and insecurity from above!
Okay...we need to eventually move on or we'll get lost in the weeds.
Before we get to CBD, let's look at the stage it acts on.
The endocannabinoid system and social anxiety
We all have one.
It's estimated to be about 600 million years old and we share it with most animals.
Scientists have only known about it for about 2 decades.
It's generally tasked with balancing three other key systems in the body:
- Nervous system - neurotransmitter signaling such as GABA, Glutamate, and Serotonin
- Immune system - inflammatory response, repair, and cellular growth/death balance
- Endocrine system - hormones such as histamine
You can learn all about the endocannabinoid system and general anxiety here.
Let's look at social anxiety including the specific topics covered above:
- Amygdala - Prefrontal cortex signaling
- Serotonin signaling
- Pregenual Anterior Cingulate Cortex
- Fear Extinction
Let's first introduce two key endocannabinoid players in our brains:
- 2-AG
- Anandamide
These are cannabinoids that are found naturally in our brains.
They are directly involved with social anxiety:
studies targeting cannabinoid receptors and transmitters [anandamide and 2-arachidonoyl- sn-glycerol (2-AG)] have found regulatory effects, particularly in social anxiety and social reward, as well as endocannabinoid dysregulation in social impairment related to neuropsychiatric conditions.
https://www.cell.com/trends/neurosciences/pdf/S0166-2236(17)30077-2.pdf
They originally discovered the connection between anandamide signaling and oxytocin pathways through studies on autism:
They further suggest that oxytocin-driven anandamide signaling may be defective in autism spectrum disorders
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4653148/
Oxytocin is interesting for social anxiety. It's literally the chemical that spurs bonding and social reward in the brain.
Interestingly, in the main study below, people with general anxiety didn't have different levels of oxytocin but people with social anxiety had elevated levels!
https://www.ncbi.nlm.nih.gov/pubmed/18801109
One of the key differences between general anxiety and social anxiety may involve this effect of oxytocin.
Why does that matter for the endocannabinoid system?
Just this….
The results indicate that anandamide-mediated signaling at CB1 receptors, driven by oxytocin, controls social reward.
https://www.ncbi.nlm.nih.gov/pubmed/26504214
That's the social reward side of the equation. Maybe too much signaling there with social anxiety.
What about social rejection?
That's really what is driving social anxiety (as opposed to general anxiety).
Now let's look at Anandamide...a key player in all this.
This is the 2nd most prominent endocannabinoid found in our brain (behind 2-AG).
It's directly involved in fear extinction (forgetting bad experiences), stress-response, and threat detection).
Basically, the attributes of social anxiety!
This thorough study showed that anandamide in the Amygdala (from the anxiety circuit above!!) addresses all three attributes:
Our findings show that augmenting amygdala anandamide enables extinction-driven reductions in fear in mice and may promote stress-coping in humans.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3549323/
Remember that some key causes of social anxiety deal with traumatic events from the past.
- Parenting style (negative or overprotective)
- Trauma - generally social in nature
These events can "marbleize" in the brain.
The beauty is that the brain can learn new tricks and erase old ones!
That's fear extinction.
It's goes to the heart of neurogenesis and CBD has a big role there.
This is basically the entire premise behind CBT Cognitive Behavioral Therapy.
To retrain the brain.
Even anxiety medication was shown to "thicken" the prefrontal cortex which helps to control our Amygdala fear response!
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3691841/
There's a huge synopsis of the key cannabinoids and anxiety here:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3691841/
It's not for the light of heart but it shows how 2-AG, Anandamide, and others are intimately involved in the "process" of anxiety.
As for how the endocannabinoid system helps to control anxiety response, it partially comes down to the workhorse of the brain...serotonin:
The eCB-induced modulation of stress-related behaviors appears to be mediated, at least in part, through the regulation of the serotoninergic system
https://www.ncbi.nlm.nih.gov/pubmed/21354188
Serotonin is a key player in relaying information between the Amygdala (fear center) and the prefrontal cortex (rational brain).
Okay....we have to move on to CBD or we could stay with the endocannabinoid system for pages.
We'll leave you with one interesting study.
They basically raised mice in adolescence with social rejection.
The outcomes were as expected:
Adult ISR animals showed pronounced deficits in social interaction, social memory, processing of socially transmitted information, and decreased pain sensitivity.
https://www.ncbi.nlm.nih.gov/pubmed/27812328/
What was fascinating is that this early, negative exposure showed its effects (similar to social anxiety in people) via the endocannabinoid system:
Our data indicate lasting consequences in social behavior and pain sensitivity following peer-rejection in adolescent female rats. These behavioral impairments are accompanied by persistent alterations in CB1R signaling.
CB1 is the endocannabinoid receptor found mainly in the brain and central nervous system!
So...social anxiety is written all over this system.
Let's look at CBD now (finally).
Can CBD help with social anxiety
Again, check out the full article on CBD and anxiety here.
It goes through the mechanics of anxiety in general.
Let's look at the other aspects of social anxiety that might be different.
How about a very specific example.
Public speaking!
Isn't that the living embodiment of social anxiety in an activity!
The effects of CBD pre-treatment for social anxiety:
Pretreatment with CBD significantly reduced anxiety, cognitive impairment and discomfort in their speech performance, and significantly decreased alert in their anticipatory speech.
https://www.ncbi.nlm.nih.gov/pubmed/21307846
Maybe more importantly for social anxiety...
The SSPS-N scores evidenced significant increases during the testing of a placebo group that was almost abolished in the CBD group.
You're going to love this.
SSPN stands for "Negative Self Statement Scale".
It's a test given to evaluate a person's view on themselves!
It LITERALLY is the heart of social anxiety.
Fear of rejection. Fear of making a mistake. Fear of how others will view you.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3079847/
The words the researchers used…
"Almost Abolished".
The best part of this experiment is that a section of the participants...ready for it...
Had a diagnosed social anxiety disorder!!
We're only getting started.
So how did CBD do this?
Yes, it's shown to have powerful anti-anxiety effects but social anxiety is very specific.
Here, we're going to geek out.
Another study took a look at what was going on in the brain for anxiety and threat response when seeing fearful faces (very pertinent to social anxiety).
We'll decipher this as we go along but hold on to your hats…
In the placebo condition, BMS identified a model with driving inputs entering via the anterior cingulate and forward intrinsic connectivity between the amygdala and the anterior cingulate as the best fit.
https://www.ncbi.nlm.nih.gov/pubmed/19775500
So they used statistical analysis of brain scans to show that a circuit lit up during the experiment between two brain areas.
The amygdala (fear center) and the anterior cingulate (the pregenual ACC is part of this).
Those two areas should be very familiar with everything we discussed above.
Remember the circuit we discussed above that was very important to social anxiety?
Too much fear response and then the rational brain would ramp up the signal instead of calming it down??
Now watch what happens with CBD on this circuit.
CBD but not Delta 9-THC disrupted forward connectivity between these regions during the neural response to fearful faces.
As a wrap-up…
This is the first study to show that the disruption of prefrontal-subcritical connectivity by CBD may represent neurophysiological correlates of its anxiolytic properties.
https://www.ncbi.nlm.nih.gov/pubmed/19775500
Anxiolytic is just a technical word for anti-anxiety.
Notice how THC did nothing there.
In fact, THC is known to cause anxiety (which affects the kind of CBD we want to try).
Check out CBD versus THC or weed for anxiety to really understand the difference.
Finally, how to forget bad things.
How do we erase the brain pathways caused by abusive or negative parenting, social trauma early in life, etc?
Even chronic stress can eat at the parts of the brain that are needed to keep our fear response in check.
Neurogenesis.
The ability to create new brain pathways and erase other ones.
There's quite a bit of information for CBD and PTSD and CBD and neurogenesis articles (as expected).
A recent study showed that 1-2 uses of THC at age 14 can thicken the Amygdala (fear center).
It should be thinning out then as we become more rational.
This is part of the whole brain remodeling that goes on during puberty (ends around age 25).
A thicker and more active Amygdala makes a person prone to future anxiety.
Let's look at a specific part of this "locked-in" aspect of the brain.
Fear extinction.
Fear extinction is a fear or anxiety response to a stimulus.
For example, a social setting. Meeting a new person. Speaking around a table.
With social anxiety, there's a conditioned response to these situations that's there even in anticipation of the event.
The brain also has the ability to erase this cause-effect.
It's called fear extinction.
Let's introduce CBD.
In one study, CBD was shown to be effective in removing this conditioned response:
CBD can enhance consolidation of extinction learning in humans and suggest that CBD may have potential as an adjunct to extinction-based therapies for anxiety disorders
https://www.ncbi.nlm.nih.gov/pubmed/23307069
Another study delved deeper into the various aspects of fear extinction:
The evidence indicates that cannabidiol reduces learned fear in different ways: (1) cannabidiol decreases fear expression acutely, (2) cannabidiol disrupts memory reconsolidation, leading to sustained fear attenuation upon memory retrieval, and (3) cannabidiol enhances extinction, the psychological process by which exposure therapy inhibits learned fear.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5121237/
Interestingly, CBD does not affect normal memories!
Finally, let's look at CBD's ability to spur neuron growth in key areas:
CBD presents dose-dependent effects on cell proliferation and neurogenesis in the hippocampus and subventricular zone (SVZ).
https://www.sciencedirect.com/science/article/pii/S027858461530004X
The hippocampus is key to emotional balance and is part of the system that controls memories (both actual and emotional via the amygdala).
The subventricular zone is where new neurons are formed!!
What role does the hippocampus have with anxiety?
Adult hippocampal neurogenesis could play an important role in the genesis of psychiatric disorders such as anxiety, schizophrenia and mood disorders
In fact, that's how SSRI's actually work (when they do). See CBD versus SSRI's for anxiety.
Maybe, more importantly, stressful events reduce the neuron growth in the hippocampus:
In this way, stressful experiences, that are closely related to the development of anxiety and mood disorders, down-regulate hippocampal neurogenesis
Here's where stress comes in .
The stress of negative or overprotection parents. The stress of social rejection.
The anxiolytic effect of cannabidiol on chronically stressed mice depends on hippocampal neurogenesis: involvement of the endocannabinoid system
https://academic.oup.com/ijnp/article/16/6/1407/754216
This study showed that the anti-anxiety effect of CBD was BECAUSE of adding more firepower to the hippocampus!!
This means that a percentage of people dealing with anxiety generally and social anxiety specifically might be suffering due to brain loss at the hands of stress.
CBD boosts neurogenesis in this area.
One note...CBT or cognitive behavior therapy aims to reshape brain pathways through "learning" essentially.
Learning new responses to anxiety.
Based on what we've shown above, CBD might a valuable ally to speed the process of CBT which is usually the drawback (it takes time and effort to change the brain!).
We've looked at the following:
- CBD for brain signaling
- CBD for serotonin levels
- CBD and brain remodeling
- CBD and fear extinction
- CBD and social anxiety proxy - public speaking
Very fascinating and the researchers are only getting started.
Let's look at more practical questions.
How much CBD to take for social anxiety
Some of the more intense studies above were at 300-600 mg's of CBD.
A good starting dose is probably around 25-30 mg of CBD to test your body's response.
Check out the quick start guide for important tips such as taking with medications, how to get the most of CBD and more.
From there, you can up to test your body's response.
We actually have research on a sweet spot for the neurogenesis.
That pathway appears to operate on a bell-curve with maximum neurogenesis at 300 mg.
Check out how many mg of CBD for anxiety here.
Social anxiety is a great test for CBD dosage since you can easily find where you get relief.
Let us know what works for you or if questions come up on dosage.
Learn about CBD for phobias as well since social anxiety is starting to be pushed under that umbrella.
Let's talk about a very important aspect of social anxiety disorder.
The best CBD for social anxiety
We basically designed IndigoNaturals for anxiety.
Why?
That's how the founders came across CBD, to begin with and had to go through 3-4 of the biggest brands to get the right product.
That story is here.
Here's the deal...for anxiety, CBD Isolate is highly recommended.
Aside from the fact that all the research above is on CBD by itself (not full spectrum), there's the whole histamine issue and anxiety.
40-60% of people have allergy or histamine issues.
This is more prevalent for women (as is anxiety by the way) .
All the plant material in full-spectrum (plus maybe THC up to .3%) can cause a histamine response with very little research to back up positive effects.
We've gone through the research on histamine release and anxiety here but that fact that an antihistamine can actually be prescribed and effect for social anxiety disorder are indicative:
https://www.verywellmind.com/how-is-vistaril-used-to-treat-social-anxiety-disorder-3024963
CBD is a potent anti-histamine in its own rights and that conveys other benefits as you find in our CBD and histamine article.
Again, that's why we crafted IndigoNaturals as CBD Isolate with all the 3rd party testing and protection.
We're so excited to show the research here on CBD and Social Anxiety.
Check out:
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Master overview of CBD and anxiety pathways to look at various aspects we can directly affect.
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Links to CBD and anxiety research with dozens of anxiety-specific topics.
Always work with a doctor or naturopath with any supplement!
The information provided here is not intended to treat an illness or substitute for professional medical advice, diagnosis, or treatment from a qualified healthcare provider.